Why Aren’t We Paying More Attention to the Yellow Fever Outbreak?

If Ebola and Zika taught us anything, it’s that we cannot ignore a health crisis just because it’s happening on the other side of the world. And yet, as a yellow fever outbreak continues to spread throughout the African continent — even reaching Asia — the West has stayed surprisingly quiet on the subject.

The yellow fever outbreak started in Angola around January and is already suspected to have infected around 4,000 people in multiple countries. These include the DRC, Kenya and even China, where 11 cases have been reported. Another outbreak — apparently unrelated — in Uganda has infected around 68 others.

Outbreaks of yellow fever have occurred in different parts of the world for centuries. This includes the United States, which suffered from numerous deadly epidemics in the 1700 and 1800s.

In Africa, most outbreaks have been limited to rural areas and generally remain small. However, this time, the virus has managed to gain a foothold in some of these nation’s densely populated capitals, making the rates of transmission much higher.

What is yellow fever?

Although less deadly than Ebola, yellow fever is also considered a hemorrhagic disease. Most people who become infected will get better on their own after a few days of misery. But around 15% of the infected will go on to suffer from jaundice, bleeding and organ failure. Around half of the people who make it to this “toxic” stage will die.

The virus generally spreads after a person who doesn’t know he or she are infected travels to another village, city or country. The individual is known as the “viremic” carrier.

It just takes one mosquito to bite that human, and then bite another, for the disease to spread. The more infected, and the more vectors, the faster yellow fever spreads. That’s why the current outbreaks in urban areas of Angola and the DRC are so worrying.

The WHO warns: “Viraemic traveling patients pose a risk for the establishment of local transmission especially in countries where adequate vectors and susceptible human populations are present.”

There is a vaccine for yellow fever, and groups like Doctors Without Borders are trying desperately to immunize people in affected countries. But there simply isn’t enough of the vaccination to go around.

On top of this, in Africa it is startlingly easy to evade a mandatory vaccination. Even during times of known outbreaks, airport officials rarely check incoming or outgoing travelers. There is also a rife industry selling fake vaccination papers for those who don’t have the vaccination but still want to travel.

If and when unvaccinated people make their way to another country — like what occurred in China — there can be a rash of illnesses in a short period of time.

And much like Ebola, there is no cure for yellow fever. Those who are infected must rely on supportive care to stay alive.

The current conditions of a large Chinese expatriate community in Angola, the high volume of air travel from Angola to Asia, a favorable ecology for yellow fever transmission, and a large unimmunized population together represent a global health threat.

And he fact that the vast majority of people in these countries remain unvaccinated make them particularly vulnerable:

With increasing volumes of air travel, the international spread of emerging and vector-borne infections has become a substantial risk. This risk is particularly acute in the Asia-Pacific region, where systems for YF surveillance and detection are largely untested, and YF vaccination is limited to travelers.

It’s also important to point out that around 70% of Angolans are vaccinated from yellow fever. Despite these high numbers, the virus has managed to gain a particularly strong foothold within the nation’s capital. It’s not hard to imagine what could happen if the virus finds its way into a population with near-zero immunity.

In 2013, Peter Hotez and Kristy Murray from Baylor College of Medicine warned that unseasonably warm temperatures in the U.S., combined with the emergence of the Ae. aegypti mosquito in Houston, could make the country prone to another outbreak:

The culmination of travelers returning to Houston from endemic areas, subtropical climate, high prevalence of Ae. aegypti mosquitoes, and areas of dense housing overlapped with poverty place Houston at risk for yellow fever emergence.

When Ebola emerged, it was reported on in Africa for almost a year before it became a staple of the Western media’s 24-hour news cycle. Once Americans felt exposed, funding and demands that we “do something” helped buoy international organizations and health workers, who were eventually able to stamp out the disease in Liberia, Sierra Leone and Guinea.

You would think in such a short time span, we would remember these lessons and take appropriate action when epidemics emerge. Apparently we have a very short memory.

38 comments

"The West only cares about the West,, and that's why they've been quiet..." And the east only care about the east and the south only care about the south etc. It's natural to be more attuned to your own area of the world and the people you identify with. Yet for some reason I will never fathom, it's only bad when the west does this.

I agree that Richard `s stori is amazing, last tuesday I got a gorgeous BMW from bringing in $8127 this - four weeks past and-over, $10k this past munth . this is definitely the easiest job I've ever done . I began this three months/ago and pretty much straight away began to make more than $71 per-hr . navigate to this web-site